Don’t care commission

More evidence of the failings of the so-called Care Quality Commission (CQC) emerged today (Friday 2 December 2011) as the National Audit Office (NAO) warns that checks on English care homes are falling.

Inspections fell ‘significantly’ after April 2009, ‘due to the Commission's decision to prioritise registration over compliance’.

Now a CQC board member, Kay Sheldon, has called for the resignation of chief executive Cynthia Bower (£200,000 a year) over a failure of leadership at the regulator.

The call came in a statement to the public inquiry into the Mid-Staffordshire Hospital scandal.  Kay Sheldon said, “it is clear that a change of leadership and culture is needed to ensure the organisation is effective and accountable."

Cynthia Bower, whose pension pot grew by £240,000 last year from our taxes, was in charge of the West Midlands Strategic Health Authority which was supposed to check the performance of hospital trusts and primary care trusts, including Stafford hospital which suffered a "complete failure" of management.
Things were so bad at the hospital that between 400 and 1,200 people died ‘unnecessarily’ and there were also unacceptable failings in basic care, with decisions about who to treat left to receptionists, and patients left in soiled bedding.

·  Some of the executives who were responsible for the bodies overseeing the hospital – including bower - have landed highly paid jobs in the NHS.

The CQC was established in April 2009, combining the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission.

The NAO report said work on inspecting health and social care organisations "fell significantly"

Besides checking institutions, the CQC also has responsibility for registering them.

The report found the CQC "diverted resources in a bid to meet the statutory timetable for registration" completing just 47 per cent of its target number of compliance reviews of standards of care between October 2010 and April 2011.

Government recruitment restrictions meant 14 per cent of staff positions were vacant last September, with serious shortages of registration assessors and compliance inspectors.

The CQC has admitted failing patients who faced alleged abuse at Winterbourne View Hospital by not responding to a whistleblower, and been criticised by MPs for a drop in inspections from 2010-11, after resources were switched to re-registering care providers.

The CQC will make a full response in evidence to the Mid-Staffordshire inquiry today. However, it has released two statements rejecting Sheldon's charges, one from the organisation and one from Sheldon's fellow CQC commissioners.

The CQC has been branded “not fit for purpose” by a patients’ group. It has been accused of focusing on red tape instead of inspections and of ignoring whistleblowers.

Following this exercise, Mrs Bower will be questioned next month by MPs on the powerful Public Accounts Committee.

Early in the new year the final report by the public enquiry into Stafford Hospital, where poor care led to hundreds of deaths despite relatives raising concerns, is likely to make more criticism of the CQC. A former member of staff warned the hearing that the scandal would not have been investigated under the current regime.

A pressure group set up by relatives of Stafford victims, Cure the NHS, said these reports are unlikely to go far enough and that wholesale reform of health regulation is needed.

Julie Bailey, founder of the group, said: “We definitely don’t think the CQC is fit for purpose and the evidence we have been hearing has convinced us even more.

“We’ve had two lots of evidence from the CQC with one lot contradicting the other.

“Not only have they not been doing enough inspections, the inspectors haven’t got the experience of the hospital setting.

“Cynthia Bower should resign. But we also believe that the CQC can’t do all these things, it’s just too much.”

During the the Mid Staffs inquiry last month, CQC analyst Rona Bryce said that evidence given by her colleagues had been “aspirational”.

The hearing was told that forms intended to collect all local evidence about the quality of care at a hospital or nursing home were not always filled in, as the CQC had earlier claimed.

Risk profiles were only updated once a month because of the CQC’s workload, rather than being “constantly reviewed” as had been alleged.

Earlier this year it emerged that the CQC only carried out 7,368 inspections and reviews in the most recent financial year, half the 15,220 claimed in its annual review to Parliament.

The Health Select Committee said patients had been left at risk by the CQC’s “significant distortion” of its priorities towards registering care providers rather than inspecting failing ones.

The watchdog had almost 300 vacancies earlier this year while its deadline for putting GP practices on its books has been postponed for a year so it can catch up.

An internal review in September warned that the CQC faced more risks as the scope of its services is “large and could get larger”, while the resources at its disposal are “unlikely to change significantly”.